Exposure to ETS increases both the number of ear infections a child will experience and the duration of the illness. Inhaled smoke irritates the Eustachian tube, which connects the back of the nose with the middle ear. This causes swelling and obstruction, which interferes with pressure equalization in the middle ear, leading to pain, fluid and infection.

Ear infections are the most common cause of children’s hearing loss. When they do not respond to medical treatment, the surgical insertion of tubes into the ears is often required.